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Risk-Adjusted OMTs

Risk-Adjusted Outcomes take into account complicating factors that are often referred to as comorbidities; such as age, weight, litigation, diabetes, cancer, and heart disease. Understanding these factors are present during treatment allows providers to more accurately compare outcomes across patients.  In WebPT Outcomes, risk-adjustment is applied at the National Reports level, which allows for apples-to-apples comparison across companies.

Benefits

The use of Risk-Adjusted OMTs ensures there is an accurate comparison when evaluating the quality of care between two or more providers or clinics, therefore isolating any factors affecting the patient’s perception of care. Additionally, the use of risk-adjusted OMTs allows you to statistically compensate for differences in patient characteristics that may influence their response to care which results in a fair comparison between patients.

Factors

Risk-adjustment factors are dependent on the collection of a lot of data to apply a predictive risk-adjustment model that includes sociodemographic information:

  • Age
  • Gender
  • Race/Ethnicity
  • Education Level
  • Medical History
  • Clinical factors 
    • The severity of the problem
    • Length of time the problem has persisted
    • Other clinical indications that may be present

The statistical model can be applied to control these influences, only when a sufficient amount of data has been collected containing these factors. Only then can it be determined if the resulting change in outcome score is more likely due to these influencing factors rather than the treatment provided to the patient. 

For example, if we have two ACL reconstruction rehab patients being treated by different therapists but one patient is 30 years older than the other and suffers from knee osteoarthritis, those factors need to be considered when comparing functional gain. Let’s assume the therapists regularly use the Lower Extremity Functional Scale (LEFS) to assess improvement through both episodes of care. The risk-adjusted LEFS score accounts for age and other complicating factors. Thus, therapists are able to better—and more fairly—assess and demonstrate the effectiveness of their care. 

For this reason, all Outcome measures are only effective if they contain as much data as you or the patient can provide related to their care and treatment and are used with all your cases.  The more often PTs and OTs use the OMTs the sooner the Outcome risk-adjustment profile is available.

Available WebPT Risk-Adjusted OMTs

There are currently five risk-adjusted questionnaires available within WebPT Outcomes.

  1. QuickDASH (Disability of the Arm, Shoulder, and Hand)
  2. Lower Extremity Functional Scale (LEFS)
  3. Oswestry (ODI)
  4. Neck Disability Index (NDI)
  5. Dizziness Handicap Inventory (DHI)

Which reports show risk-adjusted data?

The National Reports contain risk-adjusted data. These are: 

  1. Clinic Ranking
  2. Clinic Report Card
  3. National Clinical Outcomes Summary
  4. National Patient Perception

Risk-adjustment only appears in these reports because the risk-adjustment process only occurs at the clinic-level, not the individual therapist-level.

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